摘要
目的探讨足月新生儿败血症的临床特点及治疗情况。方法收集2016年6月至2018年6月于本院新生儿病房住院的足月新生儿败血症资料,根据发病时间分为早发型(≤7 d)和晚发型新生儿败血症(>7 d)。回顾分析新生儿败血症临床表现、实验室检查、治疗与转归。结果足月新生儿败血症共34例,其中早发型败血症25例(73.53%),晚发型败血症9例(26.47%)。早发型败血症和晚发型败血症肺炎及化脓性脑膜炎的发生率比较差异有统计学意义(P<0.05)。早发型败血症呼吸系统症状比较明显(P<0.05),晚发型败血症神经系统症状较明显(P<0.05)。早发型败血症白细胞升高、白细胞降低、C反应蛋白(CRP)升高,与晚发型败血症比较,差异均无统计学意义(P>0.05)。本院34例足月新生儿败血症,以凝固酶阴性葡萄球菌10例(29.41%)为主,其次为大肠埃希菌9例(26.47%),无乳链球菌7例(20.59%)。早发型败血症大肠埃希菌9例(36.00%),晚发型败血症肺炎克雷伯菌3例(33.33%),差异均有统计学意义(P<0.05)。所有病例均无预后不良情况。结论早发型败血症及晚发型败血症临床表现有所不同;CRP灵敏性不高;早发型败血症以大肠埃希菌及葡萄球菌为主,晚发型以凝固酶阴性葡萄球菌及肺炎克雷伯菌等条件致病菌为主,无乳链球菌有上升趋势;应重视围产期高危因素和早期临床表现,尽早行病原学检测。
Objective To explore the clinical features and treatments of full-term neonatal septicemia. Methods 34 cases of full-term neonatal septicemia from Jun 2016 to Jun 2018 were selected, which were divided two groups: early-onset neonatal septicemia( ≤7 d) and late-onset neonatal septicemia( >7 d). The clinical features, results of lab examination,treatments and outcome of the newborns with neonatal septicemia were analyzed. Results There were 34 cases of term neonatal septicemia including 25 cases(73.53%) of early-onset neonatal septicemia and 9 cases(26.47%) of late-onset neonatal septicemia. The incidence of pneumonia and purulent meningitis between early-onset neonatal septicemia and lateonset neonatal septicemia was different(P<0.05). Respiratory system symptoms were obvious in early-onset neonatal septicemia(P<0.05), while neurologial system symptoms were obvious in late-onset neonatal septicemia( P<0.05). The cases of eocylosis, hypoleucocytosis, elevated C reactive protein(CRP), between early-onset neonatal septicemia and lateonset neonatal septicemia were not different(P>0.05), 34 ases of term neonatal septicemia in our hospital were mainly coagulase-negative Staphylococcus(29.41%), followed by Escherichia coli(26.47%). There were 7 cases of Streptococcus millis septicemia(20.59%). The differnce of Escherichia coli septicemia between early-onset neonatal septicemia and lateonset neonatal septicemia was statistically significant(P<0.05). The same to Klebsiella pneumoniae septicemia(P<0.05).There was no bad outcome among the cases. Conclusions The clinical feaures between early-onset neonatal septicemia and late-onset neonatal septicemia were different. CRP reaction was not sensitive. The pathogenic bacteria of early-onset neonatal septicemia and late-onset neonatal septicemia were different. There was an upward trend in Streptococcus millis septicemia.We should pay attention to perinatal risk factors, and early clinical manifestations. Etiological detection shoule be done as early as possible.
作者
张娜
黄国强
方润婷
ZHANG Na;HUANG Guo-qiang;FANG Run-ting(Puff Pediaric Department,Dongguan People's Hospital,Dongguan,Guangdong 523000,China)
出处
《热带医学杂志》
CAS
2019年第1期88-91,共4页
Journal of Tropical Medicine
关键词
足月新生儿败血症
早发型
晚发型
Full-term neonatal septicemia
Early-onset
Late-onset
